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Ozempic (semaglutide), Wegovy (semaglutide), and Mounjaro (tirzepatide) are medications that can help lower blood sugar in people with diabetes or hyperglycemia (high blood sugar). All three medications belong to a class of drugs called glucagon-like peptide-1 receptor agonists, concisely known as GLP-1s.
While the U.S. Food and Drug Administration (FDA) has only approved Wegovy as a weight loss drug, other GLP-1s offer possible weight loss benefits.
In your body, the GLP-1 hormone helps release insulin—a hormone that helps move glucose (sugar) from the blood into other areas of the body, where it can be used for energy. GLP-1 also helps to regulate the amount of glucose the liver makes by decreasing glucagon (a hormone your pancreas makes).
In people who are overweight or obese, the amount of GLP-1 hormone in the body is lower than usual. Therefore, providing the body with more GLP-1 may help you lose excess weight, if necessary. GLP-1 agonist medications are thought to help with weight loss in the following ways:
- Increase the amount of natural insulin available in the body, helping to move sugar from the blood
- Slow the movement of food content through the stomach, causing you to feel fuller longer
- Tell your brain that you are full, which leads to a reduced appetite and consuming fewer calories
One study found that the average weight loss difference between people who received GLP-1s and those who received a placebo drug was 4% to 6.5% in people with type 2 diabetes and 6.1% to 17.4% in people without diabetes. Another study involving people with type 2 diabetes and obesity found that one-third of people in the study lost over 5% of their starting body weight after 72 weeks.
While Ozempic, Mounjaro, and Wegovy are all GLP-1 agonists, Mounjaro is also considered a glucose-dependent insulinotropic polypeptide (GIP) agonist. The GIP hormones work similarly to the GLP-1 hormone, helping to regulate the amount of insulin in the body and making you feel fuller quicker.
Which of these medications is best for weight loss?
Ozempic (semaglutide) is FDA-approved to help control blood sugar levels in people with type 2 diabetes. This medication can also help lower the risk of cardiovascular events like stroke or heart attack in people with type 2 diabetes and heart disease. Ozempic is a once-a-week injection that starts at 0.25 milligrams (mg) and can be further increased by 0.5 mg every four weeks until you reach 2 mg doses.
Ozempic is not FDA-approved for weight loss, though it may be prescribed by a healthcare provider off-label to help with weight loss. Off-label use means a medication is prescribed for a purpose other than what it is FDA-approved for, which is common in healthcare.
Ozempic contains the active ingredient semaglutide. Many researchers have utilized the 2.4 mg dosing of semaglutide for maximum weight loss benefits. However, the maximum recommended dose for Ozempic is 2 mg. Though this may be lower than the doses often studied, it is believed that Ozempic would still aid in weight management at 2 mg.
Wegovy (semaglutide) is FDA-approved to lower the risk of cardiovascular events like stroke or heart attack in people with obesity and underlying heart disease. Wegovy is also FDA-approved to help with weight loss in adults and children over 12 years old who are living with obesity.
The recommended starting dosage for Wegovy is 0.25 mg once a week. The dose can be increased every four weeks until the maximum dosage of 2.4 mg is reached.
Numerous studies have found that Wegovy supports weight loss, specifically when given at a higher dose of 2.4 mg once a week. These studies (called the STEP Trials) found that Wegovy led to significantly more weight loss (16% weight change) over 68 weeks compared to people taking a placebo drug (5.7% weight change).
Over two years, the average change in weight loss was 15.2% in those who received Wegovy versus 2.6% in people who received a placebo.
Mounjaro (tirzepatide) is FDA-approved to lower blood sugar levels in people with type 2 diabetes. Unlike Ozempic and Wegovy, Mounjaro works as both a GLP-1 and GIP agonist. Though not FDA-approved for weight loss, Mounjaro has been shown to help with weight loss in people with obesity.
The recommended starting dosage for Mounjaro is 2.5 mg once a week. After four weeks, the dose can be increased by 2.5 mg as needed. The maximum dosage is 15 mg once a week.
Mounjaro has been studied in people with type 2 diabetes in a group of studies called the SURPASS trials. One study (SURPASS-2) specifically compared Mounjaro 5 mg, 10 mg, and 15 mg to low-dose semaglutide (1 mg) in people with type 2 diabetes.
The following chart shows the average loss in body weight with Mounjaro after 40 weeks. Measurements are abbreviated as milligrams (mg), pounds (lbs), and kilograms (kgs).
| Dosage | Average Weight Loss |
|---|---|
| 5 mg | 16.8 lbs or 7.6 kgs |
| 10 mg | 20.5 lbs or 9.3 kgs |
| 15 mg | 24.7 lbs or 11.2 kg |
When these dosages were compared to 1 mg of semaglutide, people using semaglutide lost an average of 12.6 pounds or 5.7 kilograms after 40 weeks. However, it’s important to note that a 1 mg dose of semaglutide is lower than the recommended 2.4 mg dose for weight loss.
The average weight loss over 40 weeks in the SURPASS-5 study was slightly different from the findings in the SURPASS-2 study. Those on Mounjaro lost an average of 11.9 lbs (5.4 kgs) with a 5 mg dose, 16.5 lbs (7.5 kgs) with a 10 mg dose, and 19.4 lbs (8.8 kgs) with a 15 mg dose. People who took a placebo drug gained an average of 3.5 lbs (1.6 kgs).
Before you start taking medications, it’s important to be aware of any possible side effects. While taking GLP-1s, you may experience the following:
While less common, more serious side effects of GLP-1s include:
- Fainting
- Dizziness
- Higher risk of gallstones or gallbladder disease
- High heart rate
- Increased risk of pancreatic conditions like pancreatitis or pancreatic cancer
Talk to your healthcare provider about your options if you’re interested in GLP-1s to aid your weight loss journey. Your provider can help determine which GLP-1 medication would be best for you based on your medical history and treatment goals.
For example, Ozempic may be a better option if you have type 2 diabetes and heart disease. However, Wegovy may be better if you live with obesity. It’s also important to factor in the cost of the GLP-1 medications for weight loss, as some may be covered by insurance, while others may not be.
Ozempic, Wegovy, and Mounjaro are GLP-1 medications that can help lower blood sugar in people with diabetes or hyperglycemia. These medications have become popular due to their potential weight loss benefits.
While Wegovy is the only medication FDA-approved for weight loss, all three medications can help you manage your weight. If you’re interested in learning more about these medications, talk with your healthcare provider to see if you are a candidate to take these medications.
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